April 03, 2022
Journal of the American Academy of Dermatology
TAKE-HOME MESSAGE
- This letter reflects the growing interest in using biotin supplementation for dermatologic conditions despite limited evidence of benefits in the absence of deficiency and warnings issued by the FDA regarding biotin interference in laboratory tests. Biotin is recommended by many dermatologists who may have underestimated its various laboratory abnormalities and adverse effects. Most of the patients using biotin were unaware of the FDA warning, and in many cases, patients did not report any benefit of supplementation.
- Although biotin supplementation is common in dermatologic practice, appropriate counseling regarding interference with laboratory testing and adverse events is warranted.
– Kelly B. Scarberry, MD
Written by Ashish C. Bhatia MD, FAAD Written by Eliot N. Mostow MD, MPH Written by Robert T. Brodell MD, FAAD
This is an important short note because of the frequency of biotin use by the public. Many of us have recommended biotin for years. It is a water-soluble vitamin, which is expected to do little harm even though its therapeutic benefit is negligible (plus, there is some evidence of benefit in selected studies, although the presence of high-quality evidence is low). In addition, there are no easy fixes for many nail and hair problems. Finally, biotin is inexpensive and easy to use.
This note highlights the importance of reminding patients of the potential for lab test interference in those taking biotin supplementation. This interference goes beyond troponin and thyroid tests (see Table). This list is likely to grow. We are now going to counsel our patients taking biotin to stop it 2 days before getting any blood work done.
Lab tests affected by biotin supplementation
- Thyroid
- Troponin (58.6%)
- 25-Hydroxy vitamin D
- Beta-human chorionic gonadotropin
- Hepatitis
- Human immunodeficiency virus serology
Biotin beware: Perils of biotin supplementation: Response to: “The epidemiology, impact, and diagnosis of micronutrient nutritional dermatoses. Part 2: B-complex vitamins”
Julianne M. Falotico, BA
Journal of the American Academy of Dermatology
Published: February 24, 2022DOI:https://doi.org/10.1016/j.jaad.2022.02.038